Individual provider Active NPI

Jessica Carpenter, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dumas, MS
National Provider Identifier
1467022574
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
904702 Issued in MS
Practice address
1173 Highway 370
Dumas, MS 38625-9603
Phone
(662) 587-3699
NPI assigned
Jun 30, 2021
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71015051A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 34641 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 904702 MS Primary

Addresses

Primary practice location

1173 Highway 370
Dumas, MS 38625-9603

Mailing address

1173 Highway 370
Dumas, MS 38625-9603
Phone (662) 587-3699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IN, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210726002787 MS Practitioner - Nurse Practitioner 4587067780 Reassigns benefits to 3 organizations
I20241114000328 IN Practitioner - Nurse Practitioner 4587067780 Reassigns benefits to 2 organizations
I20241217001154 TN Practitioner - Nurse Practitioner 4587067780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, shared by 15 NPIs, 737 clinicians
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, shared by 4 NPIs, 192 clinicians

Practice addresses (Care Compare)

211 US Hwy 66 E
Tell City, IN 47586-2757
Phone (812) 772-4380

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

50 Veterans Memorial Dr
Kosciusko, MS 39090-3424
Phone (662) 307-2884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
904702MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 1, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 1, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Sep 1, 2023 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
In Focus Psychiatry LLC Psychiatric/Mental Health CurrentSince Jan 14, 2024 Accepting new patients
In Focus Psychiatry LLC Psychiatric/Mental Health CurrentSince Jul 20, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 6, 2024 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

1159 W Jefferson St
Ste 204
Franklin, IN 46131

211 US Highway 66 E
Tell City, IN 47586
Phone (812) 722-4380

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

220 Oak Tree Dr
Hernando, MS 38632
Phone (662) 510-8606

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

129 N Locust Ave
Lawrenceburg, TN 38464
Phone (855) 560-4999

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1467022574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 HIGHWAY 370",
            "city": "DUMAS",
            "state": "MS",
            "postal_code": "386259603",
            "telephone_number": "662-587-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 HIGHWAY 370",
            "city": "DUMAS",
            "state": "MS",
            "postal_code": "386259603",
            "telephone_number": "662-587-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JESSICA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71015051A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "34641",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.